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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
V
B
A
H
B
U
W
O
S
U
B
S
I
E
R
U
D
E
C
O
R
P
D
I
E
R
A
C
I
D
E
M
R
R
Y
S
T
P
H
Z
B
E
Y
O
S
Y
E
O
N
A
I
M
E
R
V
L
W
I
R
N
R
J
K
M
E
I
C
Z
C
R
C
G
E
H
B
J
D
A
P
Y
S
O
E
A
Y
K
M
E
A
V
B
B
B
S
S
I
V
T
R
R
U
D
T
R
Y
S
O
D
B
X
S
J
P
L
A
C
E
Z
B
C
A
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